| NPI | 1043217433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY G ANDERSON Owner/President 651-777-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 1217) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 3048) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-02-06 |